Neuroimaging plays a crucial role in every stage of a brain tumor's care. Porta hepatis Neuroimaging's capacity for clinical diagnosis has been strengthened by advances in technology, thereby proving a critical support element alongside patient histories, physical assessments, and pathologic analyses. Through the use of novel imaging techniques, including functional MRI (fMRI) and diffusion tensor imaging, presurgical evaluations are revolutionized, improving differential diagnosis and surgical strategy. The clinical challenge of differentiating treatment-related inflammatory change from tumor progression is enhanced by novel applications of perfusion imaging, susceptibility-weighted imaging (SWI), spectroscopy, and new positron emission tomography (PET) tracers.
Advanced imaging technologies will greatly enhance the quality of patient care for individuals diagnosed with brain tumors.
Clinical practice for patients with brain tumors can be greatly enhanced by incorporating the most modern imaging techniques.
This overview article details imaging techniques and associated findings for prevalent skull base tumors, such as meningiomas, and explains how to use imaging characteristics to inform surveillance and treatment strategies.
An increase in the accessibility of cranial imaging has resulted in a heightened incidence of incidentally detected skull base tumors, calling for careful evaluation to determine the most suitable approach, either observation or active treatment. The initial location of the tumor dictates how the tumor's growth affects and displaces surrounding tissues. A precise study of vascular encroachment on CT angiography, in conjunction with the pattern and extent of bone invasion visualized through CT, effectively assists in treatment planning strategies. In the future, quantitative analyses of imaging, including radiomics, might provide a clearer picture of the link between phenotype and genotype.
The combined application of computed tomography and magnetic resonance imaging analysis leads to more precise diagnoses of skull base tumors, pinpointing their site of origin and dictating the appropriate extent of treatment.
The combined examination of CT and MRI scans allows for a more comprehensive diagnosis of skull base tumors, clarifies their genesis, and indicates the necessary treatment extent.
Employing the International League Against Epilepsy's Harmonized Neuroimaging of Epilepsy Structural Sequences (HARNESS) protocol, this article examines the fundamental role of optimal epilepsy imaging and the use of multimodality imaging in evaluating patients with drug-resistant epilepsy. Biomass pretreatment The assessment of these images, particularly in the context of clinical findings, utilizes a methodical procedure.
The use of high-resolution MRI is becoming critical in the evaluation of epilepsy, particularly in new, chronic, and drug-resistant cases as epilepsy imaging continues to rapidly progress. The article considers the wide spectrum of MRI findings pertinent to epilepsy, and their subsequent clinical import. learn more Presurgical epilepsy assessment is significantly enhanced by the integration of multimodality imaging techniques, particularly in those cases where MRI reveals no discernible pathology. By correlating clinical characteristics, video-EEG data, positron emission tomography (PET), ictal subtraction SPECT, magnetoencephalography (MEG), functional MRI, and advanced neuroimaging methods like MRI texture analysis and voxel-based morphometry, the identification of subtle cortical lesions such as focal cortical dysplasias is improved, which optimizes epilepsy localization and the choice of ideal surgical candidates.
In comprehending neuroanatomic localization, the unique contributions of the neurologist lie in their understanding of clinical history and seizure phenomenology. Integrating advanced neuroimaging with the clinical setting allows for a more comprehensive analysis of MRI scans, particularly in cases of multiple lesions, which helps identify the epileptogenic lesion, even the subtle ones. Individuals with MRI-identified brain lesions have a significantly improved 25-fold chance of achieving seizure freedom through surgical intervention, contrasted with those lacking such lesions.
The neurologist's unique function involves analyzing the patient's clinical background and seizure characteristics, which are fundamental to pinpointing neuroanatomical locations. The clinical context, coupled with advanced neuroimaging, markedly affects the identification of subtle MRI lesions, and, crucially, finding the epileptogenic lesion amidst multiple lesions. Patients displaying lesions on MRI scans stand a 25-fold better chance of achieving seizure freedom with epilepsy surgery than those without such MRI-detected lesions.
This article's goal is to educate the reader on the different kinds of non-traumatic central nervous system (CNS) hemorrhages and the wide array of neuroimaging techniques utilized for diagnosis and care.
Intraparenchymal hemorrhage, according to the 2019 Global Burden of Diseases, Injuries, and Risk Factors Study, represents 28% of the global stroke disease burden. Within the United States, 13% of all strokes are attributable to hemorrhagic stroke. Intraparenchymal hemorrhage occurrence correlates strongly with aging; consequently, improved blood pressure management strategies, championed by public health initiatives, haven't decreased the incidence rate in tandem with the demographic shift towards an older population. The latest longitudinal research on aging, utilizing autopsy data, found a prevalence of intraparenchymal hemorrhage and cerebral amyloid angiopathy amongst 30% to 35% of the patients studied.
Head CT or brain MRI is necessary for promptly identifying central nervous system (CNS) hemorrhage, encompassing intraparenchymal, intraventricular, and subarachnoid hemorrhage. Identification of hemorrhage in a screening neuroimaging study allows the blood's pattern, along with the patient's history and physical examination findings, to direct subsequent neuroimaging, laboratory, and auxiliary testing to uncover the source of the problem. After the cause is understood, the principal aims of the treatment regime are to curb the expansion of the hemorrhage and to prevent secondary complications such as cytotoxic cerebral edema, brain compression, and obstructive hydrocephalus. Additionally, a succinct examination of nontraumatic spinal cord hemorrhage will also be part of the presentation.
For rapid identification of central nervous system hemorrhage, which includes the types of intraparenchymal, intraventricular, and subarachnoid hemorrhage, either head CT or brain MRI is crucial. Once a hemorrhage is seen in the screening neuroimaging scan, the blood's structure, together with the patient's history and physical examination, informs the choice of subsequent neuroimaging, laboratory, and ancillary procedures for assessing the cause. Following the identification of the causative agent, the central objectives of the treatment protocol center on mitigating the expansion of hemorrhage and preventing subsequent complications, including cytotoxic cerebral edema, brain compression, and obstructive hydrocephalus. Moreover, a brief discussion of nontraumatic spinal cord hemorrhage will also be presented.
This article focuses on the imaging procedures used to evaluate patients presenting with signs of acute ischemic stroke.
2015 witnessed the dawn of a new era in acute stroke care, primarily due to the broad implementation of mechanical thrombectomy. A subsequent series of randomized controlled trials in 2017 and 2018 demonstrated a significant expansion of the thrombectomy eligibility criteria, utilizing imaging to select patients, and consequently resulted in a marked increase in the use of perfusion imaging within the stroke community. The ongoing debate, following years of consistent use, revolves around precisely when this supplementary imaging becomes essential versus when it inadvertently prolongs critical stroke treatment. For today's neurologists, a deep and comprehensive understanding of neuroimaging techniques, their applications, and the methods of interpretation are more crucial than ever.
The initial assessment of patients with acute stroke symptoms frequently utilizes CT-based imaging, given its extensive availability, swift nature of acquisition, and safety profile. Only a noncontrast head CT scan is needed to ascertain the appropriateness of initiating IV thrombolysis. CT angiography's remarkable sensitivity allows for the dependable detection of large-vessel occlusions, a crucial diagnostic capability. Advanced imaging techniques, such as multiphase CT angiography, CT perfusion, MRI, and MR perfusion, can offer additional insights instrumental in therapeutic decision-making for specific clinical cases. For the timely administration of reperfusion therapy, prompt neuroimaging and subsequent interpretation are always necessary in every case.
In numerous medical centers, CT-based imaging serves as the initial diagnostic tool for patients experiencing acute stroke symptoms, owing to its widespread accessibility, rapid acquisition, and safety profile. For decisions regarding intravenous thrombolysis, a noncontrast head CT scan alone is sufficient. CT angiography's high sensitivity ensures reliable detection of large-vessel occlusions. The utilization of advanced imaging, encompassing multiphase CT angiography, CT perfusion, MRI, and MR perfusion, provides additional information helpful in guiding therapeutic decisions in certain clinical presentations. All cases demand rapid neuroimaging and its interpretation to facilitate the timely application of reperfusion therapy.
In the assessment of neurologic patients, MRI and CT are paramount imaging tools, each optimally utilized for addressing distinct clinical questions. Both imaging modalities have, through significant dedicated efforts, demonstrated excellent safety records in their clinical application; however, potential physical and procedural risks still exist, which are elaborated upon in this publication.
Recent innovations have led to improvements in the comprehension and minimization of MR and CT safety hazards. Risks associated with MRI magnetic fields include projectile hazards, radiofrequency burns, and adverse effects on implanted devices, leading to serious patient injuries and even fatalities.